🎓 Dr. Freemo 🇳🇱 @freemo@social.cleverlibre.org

@commonchaffinch

Yup exactly.

@Paulos_the_fog @johnabs @rbreich

@CloudyMrs

Not sure i agree, brexit was certainly mismanaged and a cluster fuck from both the torries and labour, but the principle of not promoting global centralized governance was the right choice in principle.

@Paulos_the_fog

@commonchaffinch

Thats like treating the symptom rather than the problem.. sure it might seem to help for a short term but long term your doing more harm than good, afterall super wealthy are also wealth generators and fuel the wealth of many. Every old lady with a retirement fun is backed in part by amazon stock. You arent really ever going to get a sane symptom when you avoid the problems and focus on treating symptoms.

@Paulos_the_fog @johnabs @rbreich

@commonchaffinch @Paulos_the_fog @johnabs @rbreich

You arent preventing it even if you do limit the wealth gap, so its a moot point. If everyone had the same income with one super rich person then one person can rewrite the rules. If you have1000 rich people who are a bit less wealthy then they can collectively set the rules. Even my neighboor who has slightly kore ko ey than me can donate more generously to politicians and therefore despite a small wealth gap still can write the rules more than i can.

Short of complete communism, which no sane person advocates for really, the wealth gap is not the cause nor even relevant for the most part.

@commonchaffinch

Yes i know what you were arguing for. I am saying that the problem in your scenario isnt the wealth gap, its the fact that we have a system where wealth lets you rerwrite the rules in the first place, an issue that happens no matter thr degree of the wealth gap just to varying degrees. The issue isnt the wealthgap, its the fact that you can rewrite rules with money.

@Paulos_the_fog @johnabs @rbreich

@commonchaffinch

The issue you describe is not one with the wealth gap, the issue is that we allow people with money to write the rules in the first place. This is why i say its a distraction, under no circunstance is the wage gap thr problem, it is always peripheral and a distraction to the real problems.

Why should i be ok with a neighbor who makes twice what i do having twice the influence on who is elected? Why should i frame that as a wage gap problem at all just because it gets worse when someone makes 100x what i make. The gap isnt the problem, money = political power is. Fix democracy so it cant be bought instead.

@Paulos_the_fog @johnabs @rbreich

@VoxDei

> Well, there’s certainly enough of a debate over here about how broken the NHS is. The thing is though that because the Conservative government have been running the service into the ground for thirteen years (deliberately, some would say - they prefer the private model but they have trouble winning that argument when the NHS is working) it’s impossible to disentangle “This isn’t working because it hasn’t been funded properly” from “This isn’t working because the idea is fundamentally flawed”. The system worked fine for a long time, whether it still does so in an age where everyone is living longer is another question.

The thing is, people who beleive ins ocialized healthcare will always make excuses, its the conservatives dfault! Its no different than what people who support american-ized healthcare, there is always an excuse.

And ya know, maybe with the NHS there is some (or a lot) of truth to that, maybe the conservatives have made it far worse than it could be. The thing is, the problems we see are fairly universal to the respective types of healthcare. Pure free-market healthcare is consistently expensive, and pure socialized systems are consistently riddled with the sorts of problems I mentioned. If this were isolated to just the UK I thinkt here would be an argument there but its not.

> Open to alternatives, just deeply suspicious of anything that involves changing the motivation of the system from “We want to make our people better when they’re ill” to “We want to make a small number of people rich, the mechanism for which happens to involve making some people better.”

I certainly agree with you there, I never claimed the problem was "we should be trying to make a small number of people rich to improve healthcare". In fact I've pointed out that the american system doesnt work and it is, more or less, just that. So clearly that is not something I'd suggest. The important thing to remember here though is that those two are not your two choices.

The solution to me is simple 1) make healthcare co-op based (which is neither socialized nor capitalist in nature). 2) Ensure anyone too poor to afford the healthcare (which under a co-op system should be far more affordable) has government help and gets it for free

These two things address the major problems. It is no longer centralized, so you avoid the problem of an intentional monopoly or a central authority dictating for eveyone what "affordable healthcare" means. It gives you many options to pick from, none of which are privatized, and ensures the competition between your choices drive quality and not just choices. Finally offering support for the poor means no one will ever be forced to be without health care. It also addresses you concern of lining peoples pockets and making people rich, there is no small group of owners who can profit in such a scenario so greed is eliminate and costs arent driven up.

@VoxDei Oh and for the record, zalepelon is widely regarded as being **safer** than zolpidem, especially in children.

@VoxDei Yea that doesnt sound like it fixes the problem... Just sounds like there are two broken systems, and you are forced to pay for one (socialized) and have the option to also use the other broken system at an additional cost. I am not really hearing a solution here that addresses the fundemental issue of the two systems, for that we need something that is distinct from either.

@VoxDei In most socialized systems ive known enough about to comment (the UK isnt one) if the socialized insurance doesnt want to cover a prescription then it isnt legally allowed at all. I have never personally seen a situation where a prescription drug is legally permitted for prescription but under no circumstances covered by the insurance.

As for wait times in america, despite the reasons, which is speculative at best, the fact is havibg a financial deterrant results in much improved wait times. You can view it in reverse where if you make healthcare practically free then people will seek care for nonissues like mild colds and backlog the system. This is somethibg i see often in socialized systems where jobs often require you to bring in a doctors note to get a day off. Since its so cheap the job doesnt see this as a burden on the employees and you see a huge amount of people seeing doctors for runny noses backlogging the system. In america the idea of requiring a doctors note is just absurd.

@Paulos_the_fog If it were brexit then wouldnt it be common in other non-EU countries? Yet as far as I know other non-EU countries have no problem with food shortages.

@icedquinn reminds me at a high level of something I did once.. but mine was just a toy...

@VoxDei

> Healthcare is “free at the point of use” to patients. That’s the whole point of the UK system. So there is no cost to the patient to jack up, even if you’re going to regard a nationalised monopoly as still a monopoly.

Only partly true.. take my example. In israel a pharmecutical companies own pretty pervasive monopolies. Melatonin is a cheap product to produce and means you wont need to buy more expensive drugs to help with sleep problems. So these pham monopolies have a motivation to harm the general public by making melatonin a prescription, preventing competition and requiring you to buy expensive drugs.

To say there is no cost to the patient at point of sale is kinda pointless because there IS a cost to the patient (usually in ones taxes) and that cost is distributed to everyone. So they do exactly that, jack up prices and those prices are just baked into your taxes so it "feels" like you never see it. But you are still paying for it one way or another.

> An effective monopoly on medicine purchase under socialised systems means that pharma companies have to negotiate sensibly on price. Just look at what insulin costs in the US vs. the rest of the developed world: https://worldpopulationreview.com/country-rankings/cost-of-insulin-by-country

We covered this in the last post, on the one hand, yes it can mean more negotiating power to bring prices down. But those same monopolies can negotiate scenarios that line their pockets and harm the individual (as the example with melatonin above).

> You say that you can’t get prescriptions because they’re too expensive. Is it that they’re too expensive, or that they’re regarded as not cost-effective? The UK health system will pay for some very expensive drugs, where the proven benefit is there. Where the benefit is marginal, those resources are used elsewhere. It’s all very well saying that you can’t get expensive drugs, but that has to be set against the situation in a privatised system, where people who cannot afford [comprehensive] health cover won’t be able to access any drugs or treatment at all. Does your right to buy expensive insurance that covers marginal therapies in unlikely situations trump their right to access proven and cost-effective therapies? You can of course still buy that expensive insurance if you want to, nobody’s stopping you.

Its that they are too expensive.. in many cases we are talking drugs with very clear benefits. Take zalepalon vs zolpidem as an example. They are the same class of drugs and very similar. Zalepalon is less common and more expensive so you cant get it in many socialized medicine countries. But its application is vital as it has half the half-life of zolpidem. so for people with sleep disorders that are regulatory (time-shift) zolpidem not long cant treat it but makes symptoms worse where zalepalon can be a very effective treatment, but you cant get it despite the clear medical need due to costs.

> Waiting times are certainly a problem in the UK at the moment. But that’s a feature of a long-term failure to adequately resource the service. When the last Labour government left office in 2010, waiting times for almost everything were short. The Conservative government since then has deliberately under-funded the NHS, with the result that waiting times have soared. If you want healthcare it has to be paid for, and that’s as true under a socialised system as under a private one.

It really isnt though. There is a reason that every single socialized healthcare around the world, with almost no exceptions has significantly longer wait times than non-socialized. If it were limited to mismanagement then we would expect at least a few countries to have wait times on par or better than the USA, but thats just not what we see.

@Paulos_the_fog @johnabs @rbreich

What is extrodinary to me is that anyone thinks a wealth gap is an issue at all in its own right.

Iff you have a society where the poor have a good quality of life, and good opportunity for advancement. But there happen to be a few super wealthy people, who cares. Since wealth is not a pie,a nd others being rich doesnt imply others must have less, why do you care if there is a huge wealth gap, all you should care about is the quality of life for the majority of people... To be mad because some people performed really well and did really well is very petty and selfish.

There **is** an issue, and that is that is that the poor dont have good oppertunities, fulls top.

@Paulos_the_fog

Of course its natural it follows whats called the natural distribution and the same distribution applies to most everything in nature. It is very natural in a large population for a very small percentage to be vastly outperforming thr majority.

@johnabs @rbreich

@post

So the problem still isnt wealth inequality, the problem is that wealth buys you political power.

@rbreich

@johnabs

I dont think we are in disagreement. There is an issue, and part of that is how we treat money, sure.. the point is wealth inequality simply isnt an issue and hurts no one itself. All the other issues you mention, sure.

@rbreich